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DTaP And Polio Combination Vaccine

Nebraska rates for HCPCS 90696

A single injection protecting against four infections at once: diphtheria, tetanus, whooping cough, and polio. Combining them means one needle instead of separate injections for each. The charge covers the vaccine itself; giving the injection is charged separately.

Facilitymedian $74 · 10th–90th $51$2190%10%20%10th90th$74Professionalmedian $74 · 10th–90th $54$1200%10%20%10th90th$74$10.0$20.0$50.0$100.0$200.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$51.29
Median
$67.61
Typical High
$131.83
Aetna
Setting
Professional
Modifier
Global
Typical Low
$53.70
Median
$74.13
Typical High
$120.23
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$52.48
Median
$52.48
Typical High
$52.48
BCBS
Setting
Facility
Modifier
Global
Typical Low
$60.26
Median
$173.78
Typical High
$371.54
Cigna
Setting
Professional
Modifier
Global
Typical Low
$61.66
Median
$72.44
Typical High
$75.86
Medica
Setting
Facility
Modifier
Global
Typical Low
$40.74
Median
$70.79
Typical High
$275.42
Medica
Setting
Professional
Modifier
Global
Typical Low
$63.10
Median
$70.79
Typical High
$75.86
United
Setting
Facility
Modifier
Global
Typical Low
$154.88
Median
$251.19
Typical High
$407.38
United
Setting
Professional
Modifier
Global
Typical Low
$63.10
Median
$70.79
Typical High
$79.43